Thyroid nodule risk factors: Difference between revisions
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* Nodule that is stuck to nearby structures | * Nodule that is stuck to nearby structures | ||
* Family history of thyroid cancer | * Family history of thyroid cancer | ||
* Younger than 20 or older than 70 | * Younger than 20 or older than 70<ref name="pmid1415299">{{cite journal |vauthors=Belfiore A, La Rosa GL, La Porta GA, Giuffrida D, Milazzo G, Lupo L, Regalbuto C, Vigneri R |title=Cancer risk in patients with cold thyroid nodules: relevance of iodine intake, sex, age, and multinodularity |journal=Am. J. Med. |volume=93 |issue=4 |pages=363–9 |year=1992 |pmid=1415299 |doi= |url=}}</ref> | ||
** Thyroid nodularity increases with age . The presence of a thyroid nodule in a child is twice more likely to be a cancer than if it was in an adult.13263417 | ** Thyroid nodularity increases with age . The presence of a thyroid nodule in a child is twice more likely to be a cancer than if it was in an adult.<ref name="pmid13263417">{{cite journal |vauthors=MORTENSEN JD, WOOLNER LB, BENNETT WA |title=Gross and microscopic findings in clinically normal thyroid glands |journal=J. Clin. Endocrinol. Metab. |volume=15 |issue=10 |pages=1270–80 |year=1955 |pmid=13263417 |doi=10.1210/jcem-15-10-1270 |url=}}</ref><ref name="pmid2773619">{{cite journal |vauthors=Belfiore A, Giuffrida D, La Rosa GL, Ippolito O, Russo G, Fiumara A, Vigneri R, Filetti S |title=High frequency of cancer in cold thyroid nodules occurring at young age |journal=Acta Endocrinol. |volume=121 |issue=2 |pages=197–202 |year=1989 |pmid=2773619 |doi= |url=}}</ref> | ||
* History of radiation exposure to the head or neck | * History of radiation exposure to the head or neck | ||
* either externally from therapeutic X-radiation or internally through treatment with radioactive iodine (131I) and possibly radioactive fallout (131I) - e.g. in the case of above-ground nuclear bomb testing in Nevada in the 1950s | * either externally from therapeutic X-radiation or internally through treatment with radioactive iodine (131I) and possibly radioactive fallout (131I) - e.g. in the case of above-ground nuclear bomb testing in Nevada in the 1950s | ||
**:A history of radiation treatment to the head and neck region to treat acne, inflammation of the tonsils or adenoids, or thymic enlargement is associated with an increased incidence of thyroid nodularity and cancer . | **:A history of radiation treatment to the head and neck region to treat acne, inflammation of the tonsils or adenoids, or thymic enlargement is associated with an increased incidence of thyroid nodularity and cancer<ref name="pmid3965855">{{cite journal |vauthors=Schneider AB, Shore-Freedman E, Ryo UY, Bekerman C, Favus M, Pinsky S |title=Radiation-induced tumors of the head and neck following childhood irradiation. Prospective studies |journal=Medicine (Baltimore) |volume=64 |issue=1 |pages=1–15 |year=1985 |pmid=3965855 |doi= |url=}}</ref> | ||
* Male gender | * Male gender | ||
** the rate of cancer is twice as high in men than women (8 versus 4 percent) | ** the rate of cancer is twice as high in men than women (8 versus 4 percent) | ||
| Line 44: | Line 44: | ||
* A history of papillary thyroid cancer in at least one first-degree family member is associated with an increased risk of a nodule being malignant <ref name="pmid10030330">{{cite journal |vauthors=Lupoli G, Vitale G, Caraglia M, Fittipaldi MR, Abbruzzese A, Tagliaferri P, Bianco AR |title=Familial papillary thyroid microcarcinoma: a new clinical entity |journal=Lancet |volume=353 |issue=9153 |pages=637–9 |year=1999 |pmid=10030330 |doi=10.1016/S0140-6736(98)08004-0 |url=}}</ref><ref name="pmid1415299">{{cite journal |vauthors=Belfiore A, La Rosa GL, La Porta GA, Giuffrida D, Milazzo G, Lupo L, Regalbuto C, Vigneri R |title=Cancer risk in patients with cold thyroid nodules: relevance of iodine intake, sex, age, and multinodularity |journal=Am. J. Med. |volume=93 |issue=4 |pages=363–9 |year=1992 |pmid=1415299 |doi= |url=}}</ref> | * A history of papillary thyroid cancer in at least one first-degree family member is associated with an increased risk of a nodule being malignant <ref name="pmid10030330">{{cite journal |vauthors=Lupoli G, Vitale G, Caraglia M, Fittipaldi MR, Abbruzzese A, Tagliaferri P, Bianco AR |title=Familial papillary thyroid microcarcinoma: a new clinical entity |journal=Lancet |volume=353 |issue=9153 |pages=637–9 |year=1999 |pmid=10030330 |doi=10.1016/S0140-6736(98)08004-0 |url=}}</ref><ref name="pmid1415299">{{cite journal |vauthors=Belfiore A, La Rosa GL, La Porta GA, Giuffrida D, Milazzo G, Lupo L, Regalbuto C, Vigneri R |title=Cancer risk in patients with cold thyroid nodules: relevance of iodine intake, sex, age, and multinodularity |journal=Am. J. Med. |volume=93 |issue=4 |pages=363–9 |year=1992 |pmid=1415299 |doi= |url=}}</ref> | ||
* Hematopoietic stem cell transplantation increases the relative risk (RR) for thyroid cancer to 3.26; if transplantation occurred prior to age 10, the RR was 24.6<ref name="pmid17557958">{{cite journal |vauthors=Cohen A, Rovelli A, Merlo DF, van Lint MT, Lanino E, Bresters D, Ceppi M, Bocchini V, Tichelli A, Socié G |title=Risk for secondary thyroid carcinoma after hematopoietic stem-cell transplantation: an EBMT Late Effects Working Party Study |journal=J. Clin. Oncol. |volume=25 |issue=17 |pages=2449–54 |year=2007 |pmid=17557958 |doi=10.1200/JCO.2006.08.9276 |url=}}</ref> | * Hematopoietic stem cell transplantation increases the relative risk (RR) for thyroid cancer to 3.26; if transplantation occurred prior to age 10, the RR was 24.6<ref name="pmid17557958">{{cite journal |vauthors=Cohen A, Rovelli A, Merlo DF, van Lint MT, Lanino E, Bresters D, Ceppi M, Bocchini V, Tichelli A, Socié G |title=Risk for secondary thyroid carcinoma after hematopoietic stem-cell transplantation: an EBMT Late Effects Working Party Study |journal=J. Clin. Oncol. |volume=25 |issue=17 |pages=2449–54 |year=2007 |pmid=17557958 |doi=10.1200/JCO.2006.08.9276 |url=}}</ref> | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Prevalence of thyroid incidentalomas estimated from autopsy studies ranges from 30% to 60%. Studies comparing clinical palpation with thyroid imaging show a prevalence of 13% to 50%. Prospective studies of randomly selected patients have reported a prevalence of 19% to 67%. The risk for malignancy in asymptomatic nodules found in nonirradiated glands is 0.45% to 13% (mean +/- SD, 3.9% +/- 4.1%).
Risk Factors
Common risk factors associated with thyroid nodules
- Older age
- Iodine deficiency
- Previous history of iodine deficiency hypothyroidism
- Living in iodine deficient areas
- Family history of autoimmune diseases
- Multiparity
- Smoking
Common risk factors associated with thyroid cancers
- Hard nodule
- Nodule that is stuck to nearby structures
- Family history of thyroid cancer
- Younger than 20 or older than 70[1]
- History of radiation exposure to the head or neck
- either externally from therapeutic X-radiation or internally through treatment with radioactive iodine (131I) and possibly radioactive fallout (131I) - e.g. in the case of above-ground nuclear bomb testing in Nevada in the 1950s
- A history of radiation treatment to the head and neck region to treat acne, inflammation of the tonsils or adenoids, or thymic enlargement is associated with an increased incidence of thyroid nodularity and cancer[4]
- Male gender
- the rate of cancer is twice as high in men than women (8 versus 4 percent)
- Smoking 11863477
- Alcohol consumption 18031329
- Insulin-like growth factor 1 (IGF-1) levels
- Increased parity and late age at first pregnancy 10965973
- Hepatitis C-related chronic hepatitis (odds ratio [OR] 12.2 in one report) 17542674
thyroid nodules in men and decreased serum TSH levels in women 17666480
- Uterine fibroids[5]
Factors associated with a possible decreased risk include:
- Oral contraceptive use[6]
- Use of statins (associated with a reduced risk of nodules on ultrasound)
- reduced prevalence, number and volume of thyroid nodules 17666091
- A history of papillary thyroid cancer in at least one first-degree family member is associated with an increased risk of a nodule being malignant [7][1]
- Hematopoietic stem cell transplantation increases the relative risk (RR) for thyroid cancer to 3.26; if transplantation occurred prior to age 10, the RR was 24.6[8]
References
- ↑ 1.0 1.1 Belfiore A, La Rosa GL, La Porta GA, Giuffrida D, Milazzo G, Lupo L, Regalbuto C, Vigneri R (1992). "Cancer risk in patients with cold thyroid nodules: relevance of iodine intake, sex, age, and multinodularity". Am. J. Med. 93 (4): 363–9. PMID 1415299.
- ↑ MORTENSEN JD, WOOLNER LB, BENNETT WA (1955). "Gross and microscopic findings in clinically normal thyroid glands". J. Clin. Endocrinol. Metab. 15 (10): 1270–80. doi:10.1210/jcem-15-10-1270. PMID 13263417.
- ↑ Belfiore A, Giuffrida D, La Rosa GL, Ippolito O, Russo G, Fiumara A, Vigneri R, Filetti S (1989). "High frequency of cancer in cold thyroid nodules occurring at young age". Acta Endocrinol. 121 (2): 197–202. PMID 2773619.
- ↑ Schneider AB, Shore-Freedman E, Ryo UY, Bekerman C, Favus M, Pinsky S (1985). "Radiation-induced tumors of the head and neck following childhood irradiation. Prospective studies". Medicine (Baltimore). 64 (1): 1–15. PMID 3965855.
- ↑ Spinos N, Terzis G, Crysanthopoulou A, Adonakis G, Markou KB, Vervita V, Koukouras D, Tsapanos V, Decavalas G, Kourounis G, Georgopoulos NA (2007). "Increased frequency of thyroid nodules and breast fibroadenomas in women with uterine fibroids". Thyroid. 17 (12): 1257–9. doi:10.1089/thy.2006.0330. PMID 17988198.
- ↑ Knudsen N, Bülow I, Laurberg P, Perrild H, Ovesen L, Jørgensen T (2002). "Low goitre prevalence among users of oral contraceptives in a population sample of 3712 women". Clin. Endocrinol. (Oxf). 57 (1): 71–6. PMID 12100072.
- ↑ Lupoli G, Vitale G, Caraglia M, Fittipaldi MR, Abbruzzese A, Tagliaferri P, Bianco AR (1999). "Familial papillary thyroid microcarcinoma: a new clinical entity". Lancet. 353 (9153): 637–9. doi:10.1016/S0140-6736(98)08004-0. PMID 10030330.
- ↑ Cohen A, Rovelli A, Merlo DF, van Lint MT, Lanino E, Bresters D, Ceppi M, Bocchini V, Tichelli A, Socié G (2007). "Risk for secondary thyroid carcinoma after hematopoietic stem-cell transplantation: an EBMT Late Effects Working Party Study". J. Clin. Oncol. 25 (17): 2449–54. doi:10.1200/JCO.2006.08.9276. PMID 17557958.